Ok, sorry, I’m new to testing and just want to be able to interpret results. It is confusing when I am told that my horse is both compensated and uncompensated at once - I assume this means he’s borderline.

I'd like to hear Dr. Kellon's thought on that glucose because it's low enough that I wonder if something happened with testing - which could be throwing off the G:I ratio in the calculator and be one of the reasons you're getting mixed results as the RISQI only looks at insulin and not glucose. For the horses we see here that's a decent insulin level (as well as Leptin and ACTH) so I would continue the same management/feeding that you're using at the moment and just keep a close eye on him to make sure he's not developing any signs that the IR is becoming an issue.

I agree that glucose is far too low to be accurate - probably delay in separating the cells from the serum. The insulin is clearly abnormal for a low S/S diet but not in the acute laminitis risk range. Insulin is more tolerant of handling errors. ACTH though is also very sensitive to handling so you can't trust that result.-- Eleanor in PA

Thank you both for your input! He has zero visible signs of IR or PPID but has had frustratingly thin, sensitive soles and weak WL for many years, despite all sorts of protocols and trim changes. S l o w l y improving, but I thought it best to rule out the hormones. I will have him retested when the covid blows over and vets/labs get back to normal flow. I notice the report was generated a full month after the bloods were drawn, so that seems fishy.

As for ACTH, I have read all the material here and it is still unclear to me whether it is better to test during the seasonal rise or not? My vet seemed to think it is the only time to accurately test.

I also learn better by doing, and want to be able to competently help my clients through this process.

﻿I agree that glucose is far too low to be accurate - probably delay in separating the cells from the serum. The insulin is clearly abnormal for a low S/S diet but not in the acute laminitis risk range. Insulin is more tolerant of handling errors. ACTH though is also very sensitive to handling so you can't trust that result.-- Eleanor in PA

Hi Joule, my understanding is that testing during the seasonal rise can be helpful to tease out early PPID cases with exaggerated seasonal rises that otherwise have normal ACTH at other times of the year. That might be the best time for you to test if he has no signs of PPID, but if you're doing insulin blood work at any other time it doesn't hurt to add on the ACTH test anyways to monitor it, other than a little more money for the actual test and some more effort from your vet to prep the ACTH sample.

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